Insure Oklahoma

Purpose

Insure Oklahoma is a health premium assistance program Oklahoma has created to bridge the gap in health coverage for low-income working adults.  Under the Employer-Sponsored Insurance (ESI) option, commercial health insurance premium costs are shared by the state (60%), the employer (25%) and the employee (15%). The Individual Plan (IP) option allows people who can’t access benefits through their employer, including those who are self-employed or may be temporarily unemployed, to buy health coverage at a reduced rate directly through the state.

Contact(s)

Insure Oklahoma
P. O. Box 54200
Oklahoma City, OK 73154
(888) 365-3742
FAX:  (405) 949-9563
www.insureoklahoma.org

Eligibility

To qualify for the Individual Plan an Oklahoman must be between the ages of 19-64, meet annual gross household income limits, not be enrolled in Medicare or Medicaid, and one of the following criteria:

  • works for an Oklahoma business with 250 or fewer employees but does not qualify for Insure Oklahoma Employer-Sponsored Insurance
  • is self-employed;
  • is unemployed and qualifies for unemployment benefits;
  • has a disability and a Ticket to Work; or
  • is a college student ages 19 - 22.

To qualify for premium assistance under the Employer-Sponsored Insurance option, an employer must meet the following criteria:

  • have an operating location in Oklahoma (have a Federal Employer Identification Number (FEIN) issued from the Oklahoma Employment Securities Commission);
  • have no more than 250 employees; and
  • must be enrolled, or in the process of enrolling in, a qualified health plan.

Employees receiving health premium assistance through ESI must meet annual gross household income limits to qualify.

AT Services Provided/Covered

  • Employer-Sponsored Insurance: varies by carrier.
  • Individual Plan: Covers some AT services similar to those provided through the SoonerCare Traditional program.

AT Devices Provided/Covered

  • Aids for Daily Living
  • Mobility/Seating & Positioning

How to Get the AT

  • Applications are available by contacting Insure Oklahoma or going to their website at: insureoklahoma.org

Pieces of the Puzzle

  • Oklahoma small business owners of 250 or fewer employees that offer a qualified health plan to their employees and contribute at least 25% of premiums for qualified employees may apply for Insure Oklahoma premium subsidies for qualifying employees.
  • A qualifying employee must be between the ages of 19 to 64, have a gross annual household income below the financial guidelines and contribute up to 15% of premium cost for self or eligible spouse.
  • Insure Oklahoma pays 60% or more of the employee’s premium cost and 85% or more of the premium cost for the employee’s spouse.